Adrenal carcinoma, a rare incidental finding: case presentation

Abstract

Introduction:Adrenal carcinoma is a very rare malignancy accounting for 0.05-0.2% of all cancers(2), with an incidence 0.5-2/10 6 . Case presentation:We present the case of a 60 year old woman with impaired fasting glucose and hypertension, who was incidentally diagnosed, after a non-enhanced abdominal CT, with a right adrenal tumor of 4.5/6 cm. The mass was described as having smooth borders (Fig.1), and a heterogeneous aspect including solid parts, necrotic areas and 1 microcalcification (Fig.2) with no detection of local invasion or tumor extension. The CT scan was performed after a routine abdominal ultrasonography, that raised the suspicion of an adrenal tumor. Laboratory findings:• high fasting blood glucose (126/125 mg/dl) • low-normal ACTH (8.2 pg/mL, nv: 7.2-63.3)• normal morning serum cortizol (13.4 μg/dl, n.v.: 3.7-19.4) with insufficient suppresion after the over night and the two-day low dose dexamethasone tests (3.3/2.7 ug/dl)